Los Angeles Health Officials Investigate Typhus Outbreak

Los Angeles County Department of Public Health (Public Health) is investigating an outbreak of flea-borne typhus cases in downtown Los Angeles.

In an email, the Office of Communications and Public Affairs told Contagion® that there have been 11 cases associated with this outbreak and 64 total cases in 2018.

Typhus is endemic to LA County and on average about 60 cases are reported each year. This situation is unique because of the high number of cases reported in a short amount of time.

“Although typhus normally occurs throughout LA County, we are observing several cases in the downtown Los Angeles area,” said Muntu Davis, MD, MPH, Los Angeles County Health Officer in a recent statement. “We encourage pet owners to practice safe flea control and encourage all cities in the county to ensure maintenance of their trash clean-up and rodent control activities.”

Rickesttsia typhi and R felis bacteria are found in infected fleas and their feces, which can cause typhus. The fleas can in turn come in contact with animals and pets that can pass the disease onto humans, despite the fact that animals do not get sick from typhus.

In addition to outdoor pets, fleas can come from wild animals including feral cats, rats and opossums, making areas with garbage accumulation sites that could increase the risk of exposure. While animals can pass the disease to humans, typhus is not spread person-to-person.

Health officials from Public Health are gathering additional information to pinpoint the exact locations of the cases in downtown LA. All 9 cases associated with the outbreak have been reported in individuals who have a history of living or working in the downtown LA area. Details have not been revealed about the ill, but officials indicate that some, not all, of the cases have been reported in homeless people.

According to the US Centers for Disease Control and Prevention (CDC), symptoms can begin within 2 weeks of contact and include of flea-borne typhus include fever and chills, body aches and muscle pain, loss of appetite, nausea, vomiting, stomach pain, cough, and rash.

Most people will recover without treatment, but severe cases can occur, which can result in organ damage including liver, kidneys, heart, lungs and brain if not treated.

There is no vaccine to prevent typhus, but it is effectively treated with doxycycline, which is most effective when it is given soon after the onset of symptoms.

In order to prevent contact and infection, Public Health recommends that individuals avoid contact with rats, opossums, and feral cats. In the event of exposure to fleas during outdoor activities, the CDC recommends the use of Environmental Protection Agency-registered insect repellent.

Additionally, pet owners should protect outdoor pets with veterinarian-approved animal flea control products in order to prevent any contact with infected fleas and reduce the chance of fleas entering living spaces.

This is an ongoing investigation and the Los Angeles Department of Health will continue to provide updates as they become available.

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